Erin D. Michos, M.D. Profile picture
Johns Hopkins Medicine. Associate Professor, Cardiology. Co-Editor in Chief @AJPCardio. #WomenHeartHealth #CardioObstetrics #cvPrev #echofirst She/her #BeKind

Jul 16, 2021, 5 tweets

Patients with #MINOCA were more likely to be women and have fewer traditional CV risk factors. Heterogenous pathophysiology – etiology is of great importance to guide treatment. Inge van den Hoogen #SCCT2021

#MINOCA diagnosis. Overt non-cardiac disorders need to be excluded. Also need to rule out missed obstruction and non-ischemic causes of myocardial injury. Then after MINOCA diagnosed, need to workup etiology. Inge van den Hoogen #SCCT2021

Plaque disruption and plaque erosion cause some cases of #MINOCA – diagnose with OCT or IVUS, but not CCTA. Inge van den Hoogen #SCCT2021

What about CCTA in #INOCA? # of lesions, noncalcified plaque volume, smaller lumen more important ischemia determinants than max stenosis alone. Pts w/ INOCA had more total & noncalcified plaque & more positive remodeling compared to non-obstructive CAD wi/o ischemia. #SCCT2021

In sum, role of CCTA in MINOCA is limited, but role of CCTA in INOCA seem promising. Information about burden of coronary atherosclerosis useful in both scenarios. Inge van den Hoogen #SCCT2021

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